Active NPI
Shane Nebeck
- Family Medicine Physician
- Eau Claire, WI
National Provider Identifier
1376246546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 81742
- Practice address
- 617 W Clairemont Ave
Eau Claire, WI 54701-6223 - Phone
- (715) 839-5175
- NPI assigned
- Mar 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 81742 | WI | Primary |
Addresses
Primary practice location
617 W Clairemont Ave
Eau Claire, WI 54701-6223
Mailing address
2403 Folsom St
Eau Claire, WI 54703-2435
Phone (715) 552-9784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230628001128 | WI | Order and Referring Only - Family Practice | 8729446489 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1376246546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2403 FOLSOM ST",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547032435",
"telephone_number": "715-552-9784",
"fax_number": "715-835-6370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 W CLAIREMONT AVE",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016223",
"telephone_number": "715-839-5175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEBECK",
"first_name": "SHANE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-24",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "81742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.